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Most witnessed out-of-hospital cardiac arrests (OHCA) do not receive bystander cardiopulmonary resuscitation (CPR). The incidence of laypersonsO' CPR could be increased by widespread training. We evaluated the effect of distribution of CPR educational material to high-school students in the area of Como, Italy.From January 2008 to October 2009, we distributed 3200 resuscitation manikins to pupils (62% boys, mean age 16.5 ± 0.8 years) at 20 high schools in the area of Como. All students received a kit including a personal manikin and a 27 min educational digital video disc. Furthermore, they received 40 min school training in the fundamental maneuvers of CPR utilizing the manikin. Afterwards, they were encouraged to train friends and relatives at home (second tier), utilizing the kit. Eight months later, a questionnaire was randomly submitted to a sample of 600 students (19% of the distributed manikins). The 600 kits had been used to train 1058 from the second tier (mean, 1.77 persons per pupil; 95% confidence interval 1.62–1.93). Boys had a significantly lower multiplier effect than girls: 1.45 ± 1.01 vs. 2.26 ± 1.89 (P < 0.0001). Ninety-five percent of pupils considered themselves sufficiently trained in CPR and 62.3% declared their availability to effectively practice CPR if necessary. One pupil performed an effective CPR during her mother's OHCA.CPR training can be disseminated using personal manikins distributed to pupils. Most students declared themselves trained and willing to start bystander CPR if necessary. One successful CPR was effectively performed.